Electronic Health Record Now Mandatory for German Doctors
As of January 2026, doctors must use ePA-ready systems or face billing restrictions. The electronic patient record (ePA) automatically created for all public insurance holders unless they opt out.
Germany has reached a critical milestone in its healthcare digitalization push: the electronic patient record (ePA) is now effectively mandatory for healthcare providers, and all statutory health insurance members have been automatically enrolled unless they explicitly opted out.
From January 1st 2026, software systems must be in use that have received confirmation of conformity for use of the ePA and are therefore "ePA-ready". Doctors who use systems that are not ePA-ready will no longer be able to bill their services (section 372 (3) of the Fifth Book of the German Social Code (SGB V)).
How the ePA System Works
Since January 2021, Germany has been in the process of implementing the so-called electronic patient record (elektronische Patientenakte – "ePA"). In January 2025, the "ePA für alle" version 3.0 entered a pilot phase in a selected model while simultaneously health-insurance funds began automatically creating an ePA for every person with SHI, unless they opted out. Since April 2025, the ePA has been available for use nationwide by medical practices, hospitals, and pharmacies. As of October 2025, the use of the ePA has become mandatory for physicians' offices, hospitals and other care providers.
People with public ("statutory") health insurance have the option of using electronic health records (elektronische Patientenakte, or ePA). That way, documents like medical findings and doctor's reports can be kept together in one place. The use of the ePA remains voluntary and free of charge for all insured people. If you don't want to have an ePA, you can opt out by letting your health insurer know. You can also determine which information is to be saved there and who is allowed to access it.
E-Prescriptions and the Digital Shift
The ePA integrates with Germany's e-prescription system (E-Rezept), which replaced traditional paper prescriptions. Since January 2024, prescription-only medications have mostly been prescribed electronically in the form of e-prescriptions. Known as an E-Rezept in German, these have largely replaced the pink-colored paper slips. E-prescriptions can be handed in using your electronic health insurance card (EHIC), a smartphone app, or in the form of a paper printout.
What Foreign Residents Should Know
If you have statutory health insurance (GKV) in Germany, you already have an ePA unless you actively opted out through your insurer's website or app. You can access it through your Krankenkasse's app—TK, AOK, Barmer and others all offer English-language support for managing your ePA. The system is designed to give you control: you decide which doctors can see which documents. While many expats still find the digital shift complex, having your medical records centralized can be especially helpful if you move between cities in Germany or need emergency care.
Sources
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